Infectious diseases of street children in Nairobi, Kenya

Abstract

The street children phenomenon is an increasing problem in most cosmopolitan cities of the world. UNICEF estimates that there are approximately 100 million street children worldwide. In Africa, about 70% of population live below poverty line. It was estimated in 2007 that there were 250.000 – 300.000 children living and working on the streets across Kenya with more than 60.000 of them in Nairobi. Metanalysis of currently published studies on infectious diseases in street children in large urban populations/cities of Johannesburg, Lagos, Cairo and Calcutta are presented as well as our own experiences from Nairobi. Worldwide, street children are vulnerable to illnesses, diseases and injuries, but tend to under-utilise health service. Bathing in polluted rivers, scavenging among large trash piles, eating dirty food, drinking contaminated water and sleeping outside without mosquito nets – all of these increase risk of transmission of infectious diseases among this population, particularly respiratory infections, skin infections, gastrointestinal tract infections and malaria. Street children are also at high risk for getting infected by sexually transmitted diseases, including HIV, due to multiple sexual partners, low rate of condom use and having sex under the influence of drugs and alcohol. Parasitosis, typhus and upper respiratory tract infections are the leading causes of morbidity among street children in Nairobi. Street children suffer from poor health outcomes because of their lifestyle, living conditions and lack of access to medical and social services. They depend on the existing public infrastructure as pavements, public toilets and bathrooms. Improving them would not only lead to a cleaner and more healthy urban environment, but it would decrease health expenditure related to illnesses from poor waste disposal. The same should be done to improve the availability of clean and reliable drinking and washing water in urban public kiosks. And the government of Kenya should provide free health care for street children in public hospitals.